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Antibiotic resistance: Causes and consequences

24 November, 2014

With the release of the WHO’s very first worldwide report into antimicrobial resistance earlier this year, the issue of antibiotic resistance has well and truly entered the consciousness of the mainstream public. The WHO has already declared antimicrobial resistance – a term that encompasses antibiotic resistance – to be a serious threat to public safety, and the fact that common infectious disease can no longer be treated poses severe risks for everyone

Antibiotic resistance defined

Antibiotics are a type of medication used to kill bacteria that can cause diseases and other conditions. However, since the development of the first antibiotics in the 1930s, some strains of bacteria have become resistant to our current arsenal of antibiotics. The bacteria that are resistant to not just one but many different antibiotics are referred to as multi-resistant organisms or ‘superbugs’.

Antibiotic vs antimicrobial resistance

Antibiotic resistance has received significant attention in the media in the past few years. While antibiotic resistance specifically covers resistance to antibiotics, antimicrobial resistance is a broader term that also covers drugs that are used to treat conditions caused by other microbes, including parasites, fungi, and viruses. These conditions include malaria, HIV, and candida.

Antibiotic and antimicrobial resistance has spread to all parts of the world, including Australia.

The impact of antibiotic resistance

Antibiotic resistance is highly problematic because it severely hinders our ability to treat infectious diseases. In addition, surgery is dependent on the administration of antibiotics before and after the operation. Cancer patients and patients who have received organ transplants rely on antibiotics to protect them from bacteria, as the former have compromised immune systems while the latter needs to suppress their immune systems from attacking the transplanted organs.

Without effective antibiotics, basic medical procedures and surgical operations could become very high risk because there’s a much higher risk the patient could be infected with an antibiotic microbe and be without appropriate treatment while recovering from the operation.

In addition to causing deaths and preventing basic infectious conditions to be treated, antibiotic and antimicrobial resistance will lead to steeper healthcare costs. Patients will need to spend more time in hospital in order to receive more expensive types of treatment.

Types of bacteria resistant to antibiotics

Golden staph, Neisseria gonorrhoea, methicillin-resistant Staphylococcus  aureus, vancomycin-resistant Enterococcus, and multi-drug-resistant Mycobacterium tuberculosis are just a few of the bacterium that are resistant to antibiotics.

In Australia, some types of E. coli have become resistant to fluoroquinolones, a common antibiotic. Pneumonia and bloodstream infections are also becoming harder to treat, as the microbes that cause these conditions are developing resistance.

Avoiding antibiotic resistance

Antibiotic and antimicrobial resistance are natural phenomena that occur as bacteria evolve, but human activities have accelerated the pace at which these microbes develop resistance. Some of the most common causes include erroneous use of antibiotics and antimicrobial drugs, and poor prevention and control with respect to infections.

(i) The use of antibiotics

Antibiotics are too often prescribed when they are not necessary. Sometimes patients also neglect to follow the dosage instructions, which gives the microbes an opportunity to develop resistance. In animal husbandry, antibiotics are commonly misused and overused, including over prescription by vets and in agricultural practices.

Doctors help slow the pace of growing antibiotic resistance by avoiding over-prescription. Patients should always take the entire treatment course and take the dosage in the instructed manner. Finally, antibiotics should never be shared with others.

(ii) Health care facilities and hospitals

Health care professionals are cautious about prescribing antibiotics and only use them when they are absolutely necessary. Good hygiene and suitable infection control procedures are established in hospital and other health care facilities. Note that microbes and bacteria can be passed through contaminated hands, surfaces, equipment, and other items.

Hospitals work to establish strict work practices to reduce the risk of patients being infected by superbugs. Staff are made to wash hands before and after contact with patients, and use the appropriate disinfectant solutions to do so. Protective items such as goggles, gloves, masks, and gowns should be used.

Additionally, the handling of sharps and hospital waste are carefully considered; the facility follows a protocol designed to minimise the risk of infection. If a patient is known to have an antibiotic-resistant infection, additional precautions such as dedicated equipment should be taken.

 (iii) Precautions in the general community

The general community can also follow certain measures to reduce the risk of transmitting antibiotic-resistant bacteria. Good hygiene habits, such as washing hands before and after going to the toilet or handling food, are important.

If you have a cold, use tissues to blow your nose and stay at home to avoid infecting others. Take antibiotics that are prescribed to you in the manner directed by your doctor. Through good personal hygiene, the spread of these superbugs through any community can be minimised.

(iv) Health care sector and policy makers

The government plays a vital role in slowing antibiotic resistance. Policy makers should direct their efforts to researching new vaccines, infection treatment options, and other treatments that could combat antibiotic resistance.

Sources:

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